Archive for Innovation

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It’s Not Too Late to Launch CCOF on January 1st

Plan Your 2017 Collection Strategy Using CCOF

High Deductible Plans and CCOF Are Becoming Mainstream

When we first starting teaching practices how to implement credit card on file (CCOF) in their practices in 2010, only a few practices had ever heard of it. Today, we get calls weekly from practices who need help collecting patient balances, especially from patients with high-deductible plans, many whom do not understand how their plan works. Note that almost 25% of persons covered by employer health plans are enrolled in high-deductible plans, and almost 90% of enrollees in the healthcare exchange (Affordable Care Act Marketplaces) have a high-deductible plan!

The time-honored tradition of sending patients monthly statements and allowing them to pay on their own timetable has increasingly become untenable for medical practices, especially small practices that have limited financial resources to wait out patient payments. Physicians are paying their staff, medical supplies, utilities and rent monthly while waiting for insurance plans to pay in 30 to 45 days and patients to pay anywhere from 60 to 120 days or more past the date of service.

Having the Talk With Patients

Credit card on file opens the patient payment dialogue by changing the conversation from “We’ll send you a bill when insurance pays their portion” to “Once we receive the insurance Explanation of Benefits (EOB), we’ll charge your card for the patient-responsible balance. If the balance is over $____, we’ll call you to discuss your payment.”

On January 1st, the deductible starts afresh for most plans, and any practice not using credit card on file to collect those deductibles is in for a particularly tough quarter – what I’ve always called “The Black Months”. With the size of deductibles however, many practices are in for another tough year. Contrary to plans of the past that applied the deductibles only to very high-priced services or hospital events, many deductibles apply to office visits, medications, labs – essentially every healthcare service one can have. Some patients will never meet their deductible and will be paying your practice out of their pocket for every service all year long.

Is 2017 the year you streamline and improve patient collections?

It’s not too late to get it together to launch your program now to be ready for the new year. Here are the steps:

  1. Integrate software that allows you to keep patient credit cards on file on an offsite, secure, third-party server as an add-on to your current merchant services (credit card processing). Call your current credit card processor to see if they have CCOF, but be careful – there is a lot of confusing language around the CCOF part and CC processing charges. My recommendation for CCOF software is here.
  2. Educate patients on the change. Inform and educate patients about your new policy between now and when you launch.
  3. Rewrite your financial policy to include CCOF. If no one ever reads your financial policy, now is the time to make it simpler and clearer.
  4. Educate the staff. Explain why you’re making the change, how it works and how to communicate with patients that might have questions.
  5. Change your patient scripts to include CCOF language when you schedule and confirm appointments.
  6. Get rid of patient statements. Decide how you will handle current patient statements to clear those balances. You eliminate statements when you implement CCOF.
  7. Determine your philosophy. How are going to deal with patients who say they don’t have a credit or debit card, or refuse to give you their card to place on file? Most practices will lose a few patients, but it is always less than you expect. Most patients who refuse are patients who never intended to pay you anyway!

I ask physicians this question:

If you collected the same amount of money each month whether you saw 500 patients who paid you part of what they owed, or 350 patients who paid you everything they owed, which would you prefer?

Of course, every physician would love to see less patients, having more quality time with each patient! What’s wrong with having a practice full of patients who agree to pay you what they owe? FYI, CCOF does not mean you cannot also serve patients who need help with medical expenses – that’s a different conversation!

For more information and help, see our CCOF page here, or watch this 30-minute YouTube video here.

NOTE: I use the term “credit card” in this article, but you can accept, if you so choose, debit cards, health savings account cards, flexible spending account cards – even gift cards.

Posted in: Collections, Billing & Coding, Day-to-Day Operations, Finance, Innovation

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Heart Failure Patient Innovation Leads to New Service Line

Transitional Care for Heart Failure Patients

Setting up new practices and healthcare businesses gives me the opportunity to meet some very creative and dedicated people. An exceptional case in point – Elizabeth Blanchard-Hills, the founder of CareConnext. She and I met several years ago while she was piloting a Transitional Care Management program for Heart Failure patients and she wanted a business model to match the care model.

Fast forward several years,and Elizabeth has taken her experience and her success and made it available to organizations who are looking for a proven way to improve care to patients, reduce healthcare costs by preventing hospital readmissions, and improve patient satisfaction.

Elizabeth agreed to an interview to update me on CareConnext.

Mary Pat: What is CareConnext?

Elizabeth: CareConnext is a care transition service giving heart failure patients renewed hope and a sense of personal control over their emotional well-being and physical health. Patients meet weekly for one month in a small group; they are coached by a multidisciplinary team and encouraged by their peers.

Mary Pat: Why would CareConnext be of interest to hospitals, physician practices or home health agencies?

Elizabeth:Hospitals interested in lowering their heart failure readmissions and improving their HCAHPS scores would benefit from CareConnext. Nurse practitioners and doctors who want to increase revenue by saving time would also benefit from CareConnext, as Medicare and private insurers will pay for this model of care. Home health agencies tell us CareConnext offers them a unique marketing edge over their competitors.

Mary Pat: What is the science behind CareConnext?

Elizabeth: CareConnext is the result of a randomized clinical trial (then called SMAC-HF) which followed more than 200 patients for five years. The results were recently published in Circulation, an American Heart Association journal for cardiologists.

Mary Pat: What is the business rationale for CareConnext?

Elizabeth: My company currently has the privilege of “transitioning” the results of the randomized clinical trial into practice.  We have been conducting an on-going pilot project with The University of Kansas Hospital since November 2013, and our results are corroborating the results of the randomized clinical trial. Happily, we also discovered that Medicare and private insurers are willing to pay us for the work we do. This is an important benefit when attempting to persuade executive leadership to implement CareConnext.

There are dozens of very good interventions for heart failure, such as software solutions or post-discharge case management tools. Very few are able to pay for themselves; fewer still have the rigor of a randomized clinical trial behind their results.

Mary Pat: What are the main findings of the study?

Elizabeth: That we could, in fact, significantly lower hospital readmissions among heart failure patients.

Mary Pat: What was most surprising about the results?

Elizabeth: We have found several surprises:

  • The importance of managing emotions when managing a chronic disease such as heart failure;
  • The randomized clinical trial showed depression puts heart failure patients at risk for readmission; this mirrors what we are now finding in the literature; helping patients feel emotionally and spiritually better is now a signature piece of CareConnext. We screen for depression using the PHQ9, and watch our patients rebuild hope by regaining a sense of control. We do so by talking frankly and directly about sensitive issues that are often time-consuming to address: end-of- life planning, the loss of independence, or asking family members to participate in a change of diet.
  • The value of peer-to- peer coaching; because of the time constraints we as health care professionals face, we too often resort to “lecturing” our patients, leaving us little time to validate our patients’ understanding, or their ability to take positive action. For example, it is easy to “tell” someone to limit their sodium intake to 2 grams a day. But does the patient even understand how to read a food label? If not, would he or she feel comfortable revealing that? CareConnext provides a safe environment for patients to recognize and overcome knowledge gaps, as they rely on one another for real-life strategies and emotional support. Our providers are mostly on “standby,” available to address specific questions or misconceptions that specifically require the expertise of an advanced practice nurse or physician.
  •  Our data holds across varying patient populations; patients who struggle with literacy or language benefit from our intervention as do patients who are affluent, well-educated and compliant. Only the “sickest of the sick” (Heart Failure Class III and IV) were included in the randomized clinical trial.
  • Our physicians and nurse practitioners enjoy the CareConnext model, too. Our team is quite talented, and therefore much in demand at The University of Kansas Hospital. They are often recruited for interesting projects always in play at a large academic medical center. They tell us CareConnext is professionally rewarding, and a welcome change from the standard, one-on- one office visit.

Mary Pat: What should clinicians and patients take away from your report?

Elizabeth: This particular patient population will remain engaged if they find something of value. Being “noncompliant” is a convenient label we often misuse with our patients. Heart Failure patients have logical reasons for being skeptical of what they perceive as “yet another doctor’s appointment,” such as a lack of energy.

We have been quite strategic in attempting to meet our patients’ emotional needs. The “clinical stuff” (monitoring fluid volume, especially overload) we offer as part of CareConnext are the ‘greens fees’ we pay so we can address and change patient behavior.  By making patients feel emotionally and spiritually empowered, we help them change the feelings they have and the choices they make.

Mary Pat: How does a reader get more information?

Elizabeth: Many organizations have approached us over the past couple of years about implementing CareConnext within their own institutions, using their own staff. We now have the experience, “lessons learned” and tools to help them be successful. Readers can email me directly to start the conversation at ehills@careconnext.org and can also visit our website: www.careconnext.org

Mary Pat: Anything else you’d like to say about CareConnext?

Elizabeth: Yes, I’d like to give you a special shout-out, Mary Pat. I first approached you with what I saw as an insurmountable problem several years ago: We had a unique care model that delivered outstanding outcomes for patients with Heart Failure, but no way to get paid for it. Using both common sense and a “roll up your shirt sleeves” approach, you helped us figure it out. Now I am excited to help others do the same, and I am grateful for your belief in me, my team and CareConnext.

Mary Pat: Thank you for the kind words, Elizabeth!

 

Elizabeth Blanchard Hills, BSN MSJ Founder of CareConnext for Heart Failure Patients

ehills@careconnext.org

800-794-0118 (w)

913-485-0387 (m)

www.careconnext.org

 

Posted in: Collections, Billing & Coding, General, Innovation, Medicare & Reimbursement

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Telemedicine Pioneers: HiTech-Doctors

Communicating With Our Physicians At Home

 

 

 

 

 

 

 

We introduced readers to HiTech-Doctors several years ago before the telemedicine boom really hit. Today, many physicians are thinking seriously about telemedicine and how adding it to their practices could meet patient demand for convenience and ease overcrowded schedules. We decided to catch up with Philip Gideon, MD, cardiologist and Chief Medical Officer of HiTech-Doctors and see what’s new.

Mary Pat: Describe HiTech-Doctors.

Dr. Gideon: HiTech-Doctors is a web-based heath care portal created to open Internet communications between provider and patient. We seek to create the safest and easiest environment for videoconferencing encounters, electronic messaging, clinical data entry, data transfer, and clinical education. Connected care is the future and is here.

 

Mary Pat: How can a practice improve patient communication using HiTech-Doctors?

Dr. Gideon: We have a high definition videoconferencing service with quality and utilities not yet seen in this industry.

  • We have developed an email service that allows safe communication with your patients.
  • For each encounter a history and physical document is generated. This data can be used in the normal workflow of generating the electronic patient chart.
  • There is a patient data entry service that allows general clinical data to be populated by the patient.
  • Interactive encounter scheduling is available to make life easier for the patient and the provider.
  • Other providers and family members can be invited into the video encounter.
  • The patients can transmit their health information in to their chart.

 

Mary Pat: How has HiTech-Doctors evolved?

Dr. Gideon: We wanted to create the next generation of electronic health record. An EHR is needed that allows the provider and patient to communicate and learn through multiple technologies in a safe easy way. We have begun to accomplish this “open chart” with our current system platform.

Additionally, the platform needed to aid providers in meeting Meaningful Use (MU) criteria for participation in government incentive programs. MU2, and particularly MU3 criteria, have some specific technological requirements that cannot at this time be fully met by most available EHR providers. We have been able to meet many of these criteria by:

  • Demographic recording and record of smoking status
  • Patient-generated data entry (medication reconciliation, BP, heart rates, blood sugars, weights, BMI, etc.)
  • Use of secure electronic messaging to communicate with patients
  • Allowing immediate ability for patients to view and download their encounter record by both document and video format.
  • Increasing after hours provider accessibility
  • Gives ability to provide summary of care record electronically

There are so many useful aspects to the platform. We believe that as MU criteria evolve and the repealed SGR mandates develop, our product will lead in the industry. We believe that, but we know HiTech-Doctors will lead in health care communication.

 

Mary Pat: What does it cost physicians and patients?

Dr. Gideon: For the provider, it is $300 for lifetime enrollment. No additional charge for individual providers.

The communications platform (secure electronic messaging or emailing) is $300 per month per practice.

For the patient, it is $20 lifetime enrollment for an individual and this includes family.

$10 will be added to the patient bill in all encounters as payment for the service to HiTech-Doctors.

 

Mary Pat: Does insurance pay for telemedicine?

Dr. Gideon: Provider practices are encouraged to notify private insurance providers of the intent to see their patients by telemedicine. The intent should state that the encounter would be billed at an appropriate level of office visit using a QT modifier. The patient would be billed a set amount which should be considered a copay or as part of the total reimbursement. A description of the service being used (HiTech-Doctors) and the cost of service should be included. Some insurance carriers may need to negotiate the fee schedule, but this is commonplace when a new service is offered in a practice.

Encounters can alternatively be billed by the provider as cash or fee-for-service. This is specifically true for Medicare and Medicaid patients using the system outside of Medicare/Medicaid telemedicine criteria (cms.gov).

Either means of payment require a credit card transaction prior to starting the encounter.

 

Mary Pat: How does a practice implement telemedicine?

Dr. Gideon: The Hitech-Doctors team has put together an implementation plan to accommodate any office or medical center.

  1. Setting up computers, tablets and phones to accommodate the best virtual experience.
  2. Modification of patient scheduling workflow to allow a choice of in office or online encounters.
  3. Acquire and categorize patient email contact list.
  4. Email, postal, and in office advertisement of the new online service.

The implementation involves strategic scheduled learning teams early in the initiation. Both in-person and online availability of the HiTech-Doctors team is present as the roll out takes place and after. This combination of staff and provider education, hardware setup, advertisement, and ongoing technical and clinical support offers the best success.

 

Mary Pat: Is there technical support?

Dr. Gideon: Yes, 24/7 technical and user support are available buy phone at 1-480-588-2512. Try it!

 

Mary Pat: Since we last talked, the national conversation about telemedicine has changed radically. How has the conversation changed HiTech-Doctors?

Dr. Gideon: HiTech-Doctors has continued to promote the use of telemedicine as another form of patient:provider communication. Many levels of acceptance and regulation of video encounters need to be in place to allow broad use of telemedicine. This is the conversation at present, and it will need to continue. HiTech-Doctors hopes to help keep the momentum in the right direction towards sustaining the patient doctor relationship.

 

Mary Pat: What do you think about the interstate telehealth licensing compact?

Dr. Gideon: The compact addresses serious questions about healthcare, such as physician shortage in both rural and urban regions and poor access to care. Telemedicine stands to be an efficient tool in the solution.

There are tremendous benefits to having interstate licensure. Electronic visits are already a proven means of healthcare communication that can be gap-filling technology where there is poor access to healthcare. The compact has had progressively more backing by states and congressional leaders. Allowing providers to have interstate license gives the ability to optimize the use of the available technology.

Recently UHC announced it would cover telemedicine services for its subscribers, however, only if the services were procured through specific telemedicine intermediaries. What are your thoughts about this development?

Insurance providers are at a stage where they need to, and can, set the physician fee schedules for telemedicine given no specific value or code has been yet assigned by CMS. Blue Cross Blue Shield of Arizona recently also consented to paying for telemedicine at only 80% of the billed visit. United Healthcare doing business with only specific telemedicine companies is a normal practice of insurance providers in this current time of managed healthcare. HiTech-doctors offers a platform that allows real medical practice to occur. It is far more than triage to keep insurance company clients out of the ER or urgent care. The real winner is the telemedicine service that allows confident and safe communication.

 

Mary Pat: What is in the future for HiTech-Doctors?

Dr. Gideon: We are excited to move with the growing pains of our healthcare system so that we stay connected to actual need. Technology through HiTech-Doctors will continue to help in producing the best health outcomes at a low cost. The other side of the HiTech-Doctors healthcare portal is better outcomes and living.

More information on HiTech Doctors is available at their website here or by calling 480-588-2512.

HTDlogo-flat-x50

 

 

Posted in: Innovation, Medicare & Reimbursement, Practice Marketing

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Wearables Will Soon Be Part of Major Shift In Medical Practice

For a long time the idea of wearable health tracking devices seemed like an idea out of science fiction, but these days the technology is real and cost effective, and wearables will have a big effect on how your practice operates. Here with more insight on the nascent wearable industry is Guest Author Anne Zieger, CEO of Zieger Healthcare. – Abe

For most doctors in private practice, the astonishing growth of health wearables has all but passed them by.

Wearable Technology Will Soon be a Major Part of Medical PracticeAccording to a leading health IT group, the use of health and fitness apps is growing 87% faster than the entire mobile industry. That’s pretty astonishing for a product category most of us hadn’t even heard of five years ago.

But to date, this hasn’t changed medical practice much. While physicians may review readings gathered by consumer-grade measurement devices such as home glucose meters, blood pressure cuffs and pulse oximeters, few are integrating data from wearables into their consult, much less integrating that data into their EMR.

The reasons for this are many. For one thing, doctors are creatures of habit, and are unlikely to change their assessment routine unless they are pushed into doing so. What’s more, their EMRs are not set up to gather fitness data in a routine and streamlined data. Then when you consider that physicians aren’t quite sure what to do with the data – short of a shocking data outlier, what does a physician do with a few weeks of exercise data? – it seems even less likely that they’ll leverage wearables data into their clinical routine.

Over the next few years, however, this state of affairs should change dramatically.

Data analytics systems will begin to including wearables data into their calculations about individual and population health. And physicians will be expected to become adept at using wearables to better track the health status of chronically-ill patients. In short, wearables should fundamentally change the way physicians care for patients, especially those at greater risk.

Here’s some examples of how this will play out.

Data analytics

In an effort to improve the health of entire patient populations, organizations such Louisiana-based Ochsner Health System are testing Apple’s HealthKit technology. Through HealthKit, which connects with Ochsner’s Epic Systems EMR, the health system will be able to pull in and integrate a wide range of consumer-generated data, notably input from wearables.

While Ochsner’s first big win came from its test with wireless scales for heart patients—which led to a 40% decrease in admissions—the bigger picture calls for clinicians to use wearables data too, leveraging it to track the health of it entire patient base.

Tracking the chronically ill

Though most wearable health bands are consumer devices, used largely by the already fit to help them stay that way, medical device companies are building a new class of wearable devices designed to help clinicians track serious chronic illnesses in a serious manner.

Phillips, for example, announced a few months ago that it had released a biosensor patch designed to track symptoms of COPD, send the data to a cloud-based central software platform using the patient’s wireless device, then route the results to that patient’s clinician via a pair of related apps. This gives the physician 24-hour access to key indicators of COPD status, including respiratory rate, heart activity and rhythm and physical activity.

Conclusion: Much more to come

The bottom line in all of this is that wireless monitoring of remote patients has already arrived, and that new uses for data from health bands and other fitness devices are likely to become a standard part of patient care over the next few years.

While no one is suggesting that the data and practical observations a doctor gathers during a fact-to-face medical visit are becoming less value, medical practice is likely rely more heavily on monitoring of wearable smart bands, sensors, smart bands, sensor-laden smart clothing and more as time goes by. Now is a good time to prepare for this shift in medical practice, or risk getting left behind.

Anne Zieger of Zieger Healthcare

Anne Zieger is CEO of Zieger Healthcare

Zieger Healthcare’s team of veteran marketing communications pros will help you reach out to key healthcare stakeholders and grab their attention.  With decades of experience in the industry, we know exactly how to tell healthcare stories that sell.

 

Posted in: A Career in Practice Management, Electronic Medical Records, Innovation

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Before Starting a New Medical Practice Ask Yourself These 10 Questions

Starting a New Medical Practice: Who's the Boss?

 

 

 

 

 

 

 

 

  1. Can I go without any income from a new practice for 3-6 months?
  2. Do I have another income stream or can I continue to work part-time at the hospital or at an urgent care while I’m building my practice?
  3. Can I envision starting my practice by myself (no receptionist or medical assistant)?
  4. Do I have an existing patient base which will be interested in joining my practice?
  5. Is the community in which I want to work underserved or overserved in my specialty?
  6. Do I have a cash component to my practice that can help defray expenses while I’m building my practice?
  7. Will I be able to count on unpaid help from my spouse, family or friends to get things started?
  8. Will I be satisfied to start my practice by leasing space from another practice, or at a less-prestigious location that might not be my forever-location?
  9. Am I willing to shop for gently used and refurbished furniture and equipment for my medical practice?
  10. Will I be satisfied to use one of the free EHRs, even if it doesn’t have all the bells and whistles?
  11. Bonus Question: Do I have saved or can I borrow $20K to cover my expenses for the first 3-6 months?

Starting a new medical practice is not easy. No one should tell you that it is.

But, if you want to put in the work, make the decisions, and ultimately, practice the way you want to, then a solo practice may be a fit for you.

You may have to call your friends and family together to help you, you may have to work someplace else while you’re building your practice, but the good news is, you are the boss of you.

Posted in: Innovation, Quality, Starting a New Practice

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Bringing Physicians and Patients Together Via Smartphone? Dr.Church Has An App For That!

Text to Doctor

I am always excited when physicians design products for other physicians because they “get it.” Here’s the tale of a Midwest physician, Dr. Fred Church, who has developed  a free app  to communicate one-on-one with his patients via email or text.

Mary Pat: Dr. Church, tell me how you came to design e-Consult My Doctor, an app that lets physicians and patients communicate with the ease of email and text in a secure environment.
Dr. Church: I suppose the axiom of “necessity is the mother of all innovation/invention” applies here. I saw a growing need and had a growing entrepreneurial passion to solve the problem for more physician-patient interaction between scheduled visits. I believe we are at the precipice of still greater demand for mobile connectivity and services in America.
The premise of private communications to enhance doctor-patient relationships is not a novelty, but how to do it in a HIPAA-compliant manner that is also is simple and convenient is a significant challenge. We are delivering an elegant smartphone app that uniquely understands a busy doctor’s and patient’s lives and works to serve them. We have created a utility that enables any doctor to be a concierge-service doctor and every patient to be the beneficiary of that great personalized care – care that is direct from the doctors that know them and whom they trust.
Mary Pat: You describe e-Consult My Doctor as a tool to augment the physician-patient relationship, not replace the traditional office visit. Can you give some examples of this?

Dr. Church: In no way is our communication management tool intended to replace the face-to-face interaction and assessment between a physician and his established patient.  We have terms of service that users will explicitly understand and agree to prior to participation. Doctors will not have to worry about this being crystal clear to patients. Most reasonable people understand that emergency situations need to be dealt with in-person and this tool is not intended to deliver emergency communications.   Example Scenarios: 

  1. “Doctor, can you give me an evaluation of this mole as I think it has changed since you last saw me for my physical? You told me to watch it and document it myself on my phone… should I be seeing you now or wait until my next physical?”
  2. “Surgeon, I am three days post-op and it’s Sunday afternoon and I’m scheduled to see you tomorrow for follow-up.  Can you take a look at these two pictures of my wound to tell me if I need to go to the urgent care or ER tonight before tomorrow’s follow-up? I’m not alarmed but a little concerned at how it looks and I want to have your opinion before my scheduled follow-up.”
  3. “Doctor, one month ago I described to you during Betsy’s well-child visit the rare sounds and behavior changes I was hearing and seeing from my 3 month-old daughter and felt like I was having difficulty adequately explaining it to you. Guess what, I was able to capture it on this video with audio.  Can you listen to it and tell me your opinion if I should be concerned about it? Should I bring her back in after you view this so you can examine her again and/or do more lab workup?”
  4. “Doctor, we talked about considering certain omega 3 supplements and I want your opinion on this particular supplement (see picture of label) from XYZ that the pharmacist recommended. Do you think it’s a good one also?  I appreciate your opinion before my next follow up with you.”

Mary Pat: Foremost in everyone’s mind is the privacy and confidentiality of texting and emailing – how does e-Consult My Doctor achieve HIPAA compliance? 

Dr. Church: Our smartphone app technology uses best practice standards for data at rest and in transit using AES 256-bit encryption. Doctors and patients will have a secure login to their app so that if their phone is stolen or misplaced, the data is still encrypted and cannot be viewed without a user’s password. If a user’s account is somehow compromised, administratively we can suspend his account, his e-consulting relationships, and access to the information between those relationships.

Mary Pat: Do you see this product replacing the traditional function of a nurse triage in the medical practice?

Dr. Church: Absolutely not. In fact, it is intended to offload the burden that triage is often overwhelmed with. Traditional healthcare will always need people to properly triage communications at a doctor’s office.  Unfortunately, high volumes and increased costs mean that calls are not always responded to in a timely way. Doctors need communication tools that are portable and flexible and this describes e-Consult My Doctor.

Mary Pat: Your software has some interesting features, including a mini-EMR or PHR (Personal Health Record.) Can you describe the benefits of a mini-EMR available from a smartphone?

Dr. Church: Because our solution is much less complex than an EHR (Electronic Health Record), a single adult patient user may keep and manage all of his dependents’ information on one app securely. Our well-designed smartphone app stores all related health event reminders, vaccine history, and PHR information. The PHR on our smartphone app is viewable/editable without the requirement of an internet connection, which is a clear advantage over EHR portals.  When patients participate in managing their information and updating their PHR data between visits, it makes it easier for intake nurses/staff during scheduled visits to make sure the EHR’s data is also reflecting recent changes that may be more current than EHR updates from various sources: other urgent cares/ERs, other specialty doctors, other health providers/doctors/sub-specialists (DDS, DC, DPM, etc.), hospitals etc. One of the main advantages of patients participating in their own PHR information is it will hopefully improve PHR accuracy, contribute to better patient compliance, and help serve both patients and doctors in traditional healthcare delivery.

Mary Pat: How does the documentation of the communication between the physician and the patient get back into the practice EMR?

Dr. Church: The app will allow for exporting content via PDF and both doctors and patients will have their own copy of e-consultation data on their apps. Doctors may elect to attach the PDF of the e-consultation interaction to their respective EHR if they believe it is important enough and pertinent to a patient’s long-term record. For example, several EHRs do not have the ability to import pictures, audio, and video content which this app will easily store for minimal convenience fees.  Additionally, a doctor can simply summarize the exchange in her next scheduled office visit’s documentation if she feels the content is important enough. This will vary on an individual case-by-case basis and will be up to the doctor’s judgment.

Mary Pat: Between the secure communication and the mini-EMR, e-Consult My Doctor sounds very much like a patient portal. Can your software replace a patient portal for a medical practice?

Dr. Church: The mission of our software is to deliver a different and simpler solution for convenient communication and to augment the functionality of an EHR’s patient portal. An EHR patient portal is valuable for a singular patient to see what his doctor’s EHR documents as his current information including labs, vitals, etc.  The e-Consult My Doctor app will allow direct one-to-one communication any time and anywhere the doctor and patient are willing to participate.  One of the foundational premises of our product is that a doctor’s extra time and effort should be rewarded directly by the beneficiary… like having pay-as-you-go access to their mobile phone or email for enhanced, personalized care between scheduled visits.

Mary Pat: You have essentially designed a product that allows physicians to be reimbursed for care that they have been previously providing for free. Some patients will appreciate the convenience and be willing to pay for the personal attention and others will think it is akin to the airlines charging for luggage! How do you answer those who think healthcare is already too expensive without any additional fees? 

Dr. Church: I’m amazed how many people are willing to pay for the $1,000 – $2000 per patient per year for 24/7/365 access that they may only utilize a few times a year. I personally know concierge doctors who are eagerly looking forward to our HIPAA-compliant solution that will help them achieve better work-family life balance with our communication management tool.  We believe our smartphone app will bring a revolutionary solution that allows every doctor and every patient to participate in a concierge e-consulting relationship at a potentially lower price point. Our solution eliminates the middleman with a convenient and simple solution at a very affordable price and payment is directly and immediately received by the doctor.

Mary Pat: When will this product be available on the market and what will it cost physicians to purchase?

Dr. Church: The anticipated market delivery date is November 30, 2013. The app will be free and the basic subscription level will also be free. Users will be given a limited amount of secure storage space and may upgrade to larger amounts based on their individual needs. We will also offer a premium subscription level that will afford a larger secure space allotment and additional valuable service offerings. Our app will offer a pay-as-you-go, transactional model for the basic subscription level and a fixed-price price point for the value-minded user who wants more. Fred Church

Mary Pat: How can readers get in line to try your app?

Dr. Church: They can go to  http://e-ConsultMyDoctor.com and sign up for pre-launch information and be the first to try it out.  We invite physicians who want to be beta-testers!

Posted in: Amazing Customer Service, Electronic Medical Records, Innovation, Learn This: Technology Answers, Practice Marketing, Social Media

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What Doctors Can Learn from Hip Hop Mogul Jay-Z

Jay-Z could teach your Doctor something about MarketingDo you know who Jay-Z is?

If not, chances are your kids do. Jay-Z is one of the most successful rap artists of all time, and has parlayed that success into a career in fashion, merchandising, his own line of vodka, as well as an ownership stake in the NBA’s New Jersey Nets franchise that he recently sold to begin a new career as a sports agent. More than anything, Jay-Z has found a way to brand himself as someone who brings glamour, street credibility, and cool to any project he is involved with. His success, beyond the normal hard work and talent, is ultimately in marketing himself.

Where do Doctors come in?

The healthcare industry is focused on marketing more than ever. Declining reimbursement, increasing regulation, and the long-term shift from volume to value have turned the heat up on physicians, practices, hospitals and systems to change the way they  do healthcare business to cut costs, improve outcomes for patients and deliver more value. Cost matters now more than ever for all the stakeholders in healthcare, and with more competition comes the need for ways to separate yourself in the market, and engage with potential and current patients.

This summer Jay-Z put out a new album and he did it in a very unique way

To promote his album, Jay-Z ran a commercial during Game 5 of the 2013 NBA finals announcing that he had recorded a new album, and that it would be available to download, free of charge for the first million people to download it from a mobile app made especially for the release. The catch? The album would only be free to people who had a Samsung mobile device – a mobile phone or tablet. Jay-Z signed an exclusive deal with Samsung to promote the album (modestly titled Magna Carta Holy Grail), Samsung products and the free mobile app to get the album before it was available via retail. Because of the hype (and the price, of course) the million downloads happened almost as soon as the album was made available on July 4th.

    • Samsung purchased the albums from Jay-Z, so RIAA certified the album Platinum immediately.
    • Samsung was able to associate themselves with one of the biggest music releases of the year, and guarantee that only their current (and future) customers were first to hear it.
    • More than that, using the permissions of the mobile app, both Jay-Z and Samsung were able to get tons of valuable market research about the internet and mobile habits of the downloaders.
    • The fans (at least the first million of them with a Samsung) got a brand new album from Jay-Z for free.

This is a basic form of content marketing, but it was groundbreaking for an artist as big as Jay-Z and a company as big as Samsung.

What can doctors learn?

Market research is critical. Jay-Z made a few million selling the digital copies of his album to Samsung, but the information he gained from the app downloads was priceless for future collaborations. 

The more you know about your patient base and where they come from, the better. For niche specialists, your market might be global so you’ll need to know more about them to reach them. Market research can take many forms, from hard data from census and surveys to anecdotal methods as simple as asking one of your patients “What could we be doing better?” In a future where providers are reimbursed based on value, leveraging the data in your EMR to understand your patient population as a whole will be critical to many of your most important business operations.

You gain by giving things away for free. By buying and giving away a million Jay-Z albums, Samsung became aligned with a major force in global culture and music  – and probably sold a few phones too.

What about all of the questions you hear over and over again on the phone and in office visits? Seasonal stuff about allergies, sunburns, the flu and physicals for sports. What if you gave this info away to anyone who wanted it on your practice website? With the changes coming in the ACA, what if your practice manager wrote a post or white paper about how your patients can prepare for what will and won’t change? If your practice offers a special service that is hard to find locally for many people, what if you prepared an ebook about how your particular therapy benefits patients, or how they can change other lifestyle habits to complement their current therapy? All of these things are ways to reach a wide variety of people, gain credibility, and give away high-quality free information that can be converted to marketing leads for your practice.

Separate yourselfJay-Z probably couldn’t have released his first album in this manner. Jay-Z has been successfully building his brand for almost twenty years now though. The name Jay-Z has come to mean quality.

To compete and thrive, healthcare providers must be able to offer a level of service and execute that service in a way that makes them stand out from the crowd. If someone moves to town and Googles the name of family practice doctors in your area, do you know whose practice comes up in the results, and how you can capitalize on that? If people ask their neighbors who is the best cardiologist in town, would they say your name? If you treat a more specialized population, where do they gather to compare caregivers, and what do they say about you? To brand yourself today as a quality care provider, you have to actively highlight and grow your footprint and reputation for outstanding value and patient satisfaction.

Physicians and other healthcare providers may never listen to Jay-Z, or any rap. But chances are, Jay-Z’s marketing example could lead the way.

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Posted in: Innovation, Leadership, Practice Marketing, Quality, Social Media

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Are Patients Lost in Translation? An Interview With Dr. Charles Lee of Polyglot

Universal Medication Schedule (UMS)
Sometimes you find the most amazing things in your own backyard. In Research Triangle Park, NC, I found the wonderful Dr. Chuck Lee, President and Founder of Polyglot. I was bemoaning the lack of good translation software for healthcare and Sims Preston, CEO of Polyglot, contacted me on LinkedIn and invited me to see their product Meducation. I was fascinated by Dr. Lee’s story and I think you will be too.

Mary Pat: Dr. Lee, you had a very personal reason for starting a healthcare company that focuses on communication in different languages, didn’t you?

Dr. Lee: First, as a clinician, I’ve always believed that we need to help all our patients understand their health information so that they can make better health decisions.  To me, it’s just common sense that better health outcomes starts with better informed patients.  The challenge is that much health information is not usually written with the patient in mind.  It’s often written in high grade reading levels using medical jargon, and often only available in English.  If it is available in another language, it’s usually only in Spanish.

About one of every three US adults has some difficulty understanding health information and almost 30 million struggle with the English language – almost 10 percent.  Because I am a first generation Korean immigrant – I came to the US when I was 7 years old – I saw how my grandmother struggled to understand how to take her medications.  This is one of the reasons I became interested in this issue.

Mary Pat: How did your own experiences drive your vision for your company ‘Polyglot”?

Dr. Lee: It became very apparent that other HIT companies had little interest in serving the needs of minority populations – they said that there’s not much money in it.  They said it was too difficult, too costly, and that the market wasn’t big enough.  If you look just at the numbers, yes it may not make sense – but how do we continue to ignore almost 10 percent of the population – thirty percent if you count low health literacy! That’s when I decided to form Polyglot Systems to show that creating technology to support language and cultural needs of underserved populations doesn’t have to be hard or costly.  If our small company can do it, the big guys will have no excuse.

Mary Pat: Can you talk about the state of healthcare communication for non-English speakers in the United States today?

Dr. Lee: Just think about what it would be like for you if you were in another country and they didn’t speak English.  If you got sick and needed medical care, would you know how to read the signs? Know where to go? Know what forms you are signing? Know what the doctors were saying? What your treatment choices are? Or how to take your medicine if the bottle didn’t have English instructions?  That gives you a glimpse into what it’s like for non-English speakers in the US.

After I saw my grandmother’s pill bottles with instructions written in English that she couldn’t read, I became aware that this was not an isolated incident.  So I asked myself this: How many medication errors are caused by language barriers? Last year there were about 4 billion prescription written – that’s not including over-the-counter medications.  Just based on statistics, that would mean about 400 million prescription were given to patients who are limited English proficient.  The need was obvious.  If you include English-speaking patients who have difficulty understanding health information, this number approaches 1.5 billion prescriptions.  Have you seen some of instruction they give you at pharmacies? Even I can’t understand what much of it says.  Also, a lot of the instructions are printed in such small print that I had a hard time reading them.  So one of the features we built into Meducation was larger font support for elderly and visually impaired patients.

Mary Pat: It seems that the timing for Meducation is perfect based on the recent emphasis on patient engagement, eliminating waste in healthcare, and increasing medication compliance. How does Meducation address these?

Dr. Lee: For me, it all comes down to common sense.  We submitted our first grant proposal to the NIH for Meducation almost 10 years ago – when all those issues you mentioned should still have been issues back then, they just weren’t popular things to talk about then.

Healthcare statistics usually say that a minority of the population utilizes the majority of our healthcare resources. This includes those with heart disease, diabetes, CHF, etc.  Do we ignore them because they are the minority? Of course not.  I bet you that a significant portion of the patients with heart disease, diabetes, CHF have low health literacy and/or language barriers.  If we can make even a few percent improvements in these populations, wouldn’t it be worth doing? This just made sense to me.

I sometimes like to compare our healthcare system to the cable industry.  The cable companies spend tremendous amount on research and expense for laying fiber-optic cables in streets in front our homes.  But unless we can connect the home to the corner – what they call “the last mile” – it means nothing.  It’s the same in healthcare. Unless patients understand and act to self-manage their own condition, all our advances in healthcare will have little effect.  Patient engagement is the last mile.

Mary Pat: How does Meducation interface with EMRs?

Dr. Lee: This is our biggest challenge now.  We’ve developed APIs to make it easy for EMRs to request and download our multi-language patient information.  The difficulty has been getting many of the EMR vendor’s attention.  They are so preoccupied with Meaningful Use and certifications that they have paid little attention to patient education and engagement.  But I predict that this will start to turn around as reimbursements will force them to do so.

Mary Pat: Meducation also has videos with demonstrations on medication techniques. What types of videos are available and how can patients view them at home?

Dr. Lee: The videos focus on techniques for taking complex medicines such as inhalers, eye drops, etc., so the patients are actually benefiting from the medicine and not wasting it by using it incorrectly.  We want to expand these to include other techniques such as wound care, port care, etc. in the future.  The demos are free to patients if their healthcare provider or pharmacies use Meducation. Patients receive a card with the website and video ID so they can view it as often as they like at home.

Mary Pat: Meducation uses a universal graphic that shows patients when to take medication which seems like a great idea for communication despite the language the patient speaks – can you talk about this?

Universal Medication Schedule (UMS)

Dr. Lee: Yes, this is called the Universal Medication Schedule (UMS).  It was developed by a group of health literacy researchers at Northwestern University and Emory University.  It breaks up medication times into four times of day: morning, noon, evening, and bedtime. Over 90% of all daily meds can fit into this schedule and make taking medicines much easier to follow.  The Institute of Medicine (IOM), the American College of Physicians (ACP), and most recently the National Council for Prescription Drug Programs (NCPDP) have recommended its use.  I really like it because it helps patients remember with pictures if they have difficulty understanding written instructions.

Mary Pat: You use the word “affordable” as part of your mission for Polyglot. I am always seeking solutions that are affordable in healthcare. Can you talk about the cost of Meducation for a solo primary care physician?

Dr. Lee: You know, I wish I could give this away for free to everyone.  But we have to make this a sustainable effort.  I’ve seen so many good projects die because they didn’t have a plan to keep it funded and going beyond the grant or some other funding source.  This is one of the reasons I left academics to start our Polyglot.  That being said, our products need to be affordable for front line providers – safety nets and federally qualified health centers (FQHCs) – because they interact most often with underserved patients – and have the least financial resources.

For provider practices, the subscription list price is $50/mo for unlimited use.  That’s less than $2 day for the ability to print instructions for all your patients in 16 languages – including elderly English-speaking patients in larger fonts.  As a comparison, $2 is about what it cost to use a telephone interpreter for about 1 minute.  Mary Pat, we would be happy to provide your readers a discount on Meducation.  Just have them contact me at lee@pgsi.com.

Mary Pat: What other projects do you have planned for the future?

Dr. Lee: I think the opportunities to improve communication for patients are only limited by our imagination.  There is so much that we can do create quality literacy and language solutions and deliver it inexpensively to a wide audience.  We are currently working on a solution to reduce hospital readmission through simplified multi-language discharge instructions that can be individualized for each patient.  We are adapting this for use during home care visits as well.

Charles Lee, MD, President and Founder of Polyglot
Dr. Lee: Polyglot Systems was founded in 2001 to help our US medical community care for the 26 million Americans who are unable to communicate effectively in English. Our mission is to deliver solutions that eliminate communication barriers at every stage of the medical encounter – improving the experience of both the patient and health care provider.

For more information about Meducation, Dr. Lee invites you to visit the Polyglot websiteHe is extending a discount on Meducation to readers of this article – please contact him at lee@pgsi.com.

For another post on communicating with patients, read my post “Can Patient Safety Be Improved By Asking Three Questions?” here.

Posted in: Amazing Customer Service, Compliance, Day-to-Day Operations, Electronic Medical Records, Innovation, Quality

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5 Ways Technology Can Help Your Patient Relationship Management

Using Technology to Improve Patient Relationship ManagementPatient relationship management is about more than just healthcare issues; it’s about building a connection that leaves your patients feeling that you genuinely have their personal interests in mind. We all love to be recognized, and your patients appreciate it when you recall what their children’s names are, what you discussed with them during their previous visit, and where they went for their vacation.

It’s pretty impossible to keep track of everything if you have several hundred patients, however. That’s where technology can help you. Remember the old box of patient card files on which you’d make notes? Now, keeping track is just so much easier with the various tools available to physicians.

#1: Keep Electronic Records

If you’re a typical technophobe and don’t relate well to unfamiliar software programs, your record-keeping can be as easy as a Word or Text document for each patient. Set up a template for yourself that lists the data you want to keep track of, and simply enter the information into the file after each patient visit. Information could include fields such as:

  • Personal info
  • Family details
  • Chronic illnesses
  • Allergies
  • Medication
  • Visits

As long as you update the patients’ records diligently after every visit, this patient relationship management system will work for you, although it doesn’t enable you to communicate regularly.

#2: Use a Spreadsheet

A slightly more sophisticated way of keeping records than basic documents, Excel spreadsheets offer data sorting abilities that are useful. You can also keep all your patients’ information in one file, which saves you having to track and open multiple files. Use the worksheet tabs to categorize and group patients by type of illness or some other criteria that’s meaningful to you.

#3: Set Up a Database

There are multiple free and paid database programs available that you can use to set up a patient relationship management system. From Microsoft Office’s Access program through to Apache Open Office’s Baseand the software will not only store the information you add but generate reports, graphs, reminders and a mailing list that you can use with an email marketing program for communication purposes.

#4: Get a CRM Program

Commercial CRM programs such as InTouch CRM and BatchBook enable medical practices to store patient information,communicate via email or text message, and keep track of message opens and click throughs.  A customized CRM program can do the same for your practice. Not only does the program have the ability to store all relevant information about each patient, but you can set up alerts to identify critical changes in the patient’s condition based on data input from one visit to the next – without having to do a manual evaluation.

The patient relationship management program compares current data with data from previous consultations, such as blood pressure readings and cholesterol screening results. If the comparison generates an alert, you can proactively contact the patient to discuss it. At the same time, the system can generate automatic emailing of information to the patient to help educate him.

#5: Implement a Patient Portal

Cream of the crop is the digital patient portal, which enables you to store all information about your patients including test results. Patients get a secure login that lets them view their health records as well as make appointments online or communicate with you via a question facility or a discussion forum. You can set up automated emails based on criteria such as birthdays (personal info), allergies (seasonal) and medication refills needed.

Whatever method you choose to help you with your patient relationship management, keeping the information up to date is vital to enable it to be successful.

Greg FawcettAbout the Author: Greg Fawcett is President of leading North Carolina medical marketing firm Precision Marketing Partners. In this capacity Greg helps healthcare service entities to research their target markets, build their brands and develop creative strategies to reach patients.

Posted in: Amazing Customer Service, Day-to-Day Operations, Innovation, Leadership, Practice Marketing

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[Guest Post] – 7 Tactics to Improve Patient Retention in Your Medical Practice

Tactics For Retaining Patients in your Medical Practice MarketingAttracting new patients to your practice is one thing, but keeping them can be an entirely different issue. The days when you got to treat all members in a family from the cradle to the grave are long over, and regular attrition is an ongoing concern. You may not be able to avoid losing patients who move from their current location to another city or state, but you can try to avoid losing patients to other medical practices.

From primary care physicians through optometrists and gynecologists, patient retention is an important factor in the success of the practice. Here are 7 tactics you can use to keep your patients coming back for more.

Tactic #1: Think of Your Patients as Clients

Let’s face it, your patients need you probably more than you need them. Far too often, however, medical professionals treat patients as if they are doing them a favor by seeing and treating them. Even if it isn’t true about your practice, how certain are you that your patients feel as if you value them? By thinking of them as clients and fostering a customer service attitude among your practice staff, you can ensure that your patients feel important and cherished. The customer doesn’t always have to be right – he just always has to be king!

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Posted in: Amazing Customer Service, Day-to-Day Operations, Innovation, Leadership, Practice Marketing, Quality

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